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NPI Code Detail

MEDICARE: MARIANA PEREYRA-PITTS LICSW, LCSW

MEDICARE: MARIANA PEREYRA-PITTS LICSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker109926CA
21041C0700XClinical Social Worker28417MN

General Provider Information

NPI Number : 1124421425
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANA PEREYRA-PITTS LICSW, LCSW
Provider Business Mailing Address
First Line : 1131 COMMUNITY PKWY
Second Line :
City : HOLLISTER
State : CA
Zip : 95023-2816
Country : US
Telephone Number : 831-636-4025
Fax Number :
Provider Business Practice Location Address
First Line : 1131 COMMUNITY PKWY
Second Line :
City : HOLLISTER
State : CA
Zip : 95023-2816
Country : US
Telephone Number : 831-636-4025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2014
Last Update Date : 02/25/2026

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Directions to “ MARIANA PEREYRA-PITTS LICSW, LCSW” Practice Location

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